Accessory Vein Obliteration for Early Fistula Failure: A Myth or Reality?
Adv Chronic Kidney Dis
; 22(6): 438-45, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-26524948
ABSTRACT
Early fistula failure (EFF) is a significant clinical problem causing lower rates of arteriovenous fistulae (AVFs) use in patients with ESRD on hemodialysis. The 2 main factors amenable to treatment and widely accepted to cause EFF are stenosis anywhere in the AVF circuit and/or presence of accessory vein (av). The role of stenotic lesions in causing EFF and their treatment options are relatively better defined with clear guidelines. On the other hand, assessing the significance of an av in causing EFF and the indications for its treatment seem to lack scientific recommendations based on robust clinical data. In this article, we review the pathophysiology of EFF as pertains to the presence of av's. Current recommendations for obliteration of av, the available techniques and the evidence to support current clinical practice are discussed. The possible cons of av obliteration are highlighted, while newer concepts and the need for future clinical trials are addressed.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias
/
Derivação Arteriovenosa Cirúrgica
/
Diálise Renal
/
Falência Renal Crônica
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Revista:
Adv Chronic Kidney Dis
Ano de publicação:
2015
Tipo de documento:
Article